Insomnia is not just a sleep problem rather it can affect your health remember that a good sleep is needed for good health and quality of life. Insomnia is a common problem but many people do not seek treatment for it. Consulting a sleep specialist/physician can help identify the root cause of your insomnia. Your doctor will treat you based on the cause, your symptoms and severity of symptoms.
[Read: Diagnosis of Insomnia]
Medical condition: Before starting treatment for insomnia your doctor will try to ensure that some other medical problem like depression, painful arthritis is not causing your symptoms. In these conditions treatment of underlying condition can often cure insomnia.
Treatment for insomnia: If your insomnia does not seem to be caused by any other condition your doctor will treat insomnia based on factors such as whether it is short-term or long-term problem, effect of insomnia on your health and everyday activities.
- Short-term insomnia: For insomnia present for less than four weeks your doctor will advise:
- Good sleep hygiene or sleep habits
- if needed a short course of sleeping tablets
- Long-term or chronic insomnia: For chronic insomnia your doctor will recommend
- Cognitive and behavioral treatments.
- Good sleep hygieneor sleep habits.
- A short course of sleeping tablets (long-term use of sleeping tablets is not recommended).
Good sleep hygiene: The aim of sleep hygiene or good sleep habits is to make you aware of the factors that can possibly affect sleep. Sleep hygiene or good sleep habits that can help you sleep better include;
- Try to have a scheduled bedtime and time to wake up each morning (even on weekends and holidays). Even if you sleep late try to get up at your usual time on the morning (regardless of the amount of sleep during the night).
- Avoid daytime naps.
- Exercises regularly but do not do any strenuous or vigorous exercise for about two hours before your sleep time.
- Try to relax before bedtimeyou can practice any relaxation technique (such as deep breathing, yoga, or meditation) or do anything you find relaxing like listening to music, reading a book.
- Make your sleeping environment comfortable (dark, quiet, and cool)—if needed use earplugs or eye shades.
- If you find it difficult to sleep after going to bed, avoid lying awake in the bed leave the bedroom and go into another room and do something relaxing and quiet (like read a book )and return when sleepy.
- Avoid having alcohol, nicotine, coffee, tea, soft drinks, or diet pills before bedtime.
- Avoid heavy meal at night.
- Use the bedroom for only for sleep and sex (do not have distractions like TV, computer in the bedroom).
[Read: Risk Factors for Insomnia]
Cognitive and behavioural treatment: Aim of cognitive and behavioural therapy is to change your undesirable or negative thoughts and/or behaviours that may be possibly causing insomnia. You may be recommended any of the following therapies by your doctor:
- Stimulus-control therapy in this you are taught to associate the bedroom with sleep and help form a consistent sleep/wake pattern.
- Sleep restriction therapy this therapy aims to create mild sleep deprivation by limiting your time in bed to the actual amount of time spent asleep. And as your sleep improves the sleep time is increased.
- Relaxation training is done to reduce tension or minimize negative/obstructive thoughts that may hinder good sleep.
- Paradoxical intention the therapy guides you to stay awake and avoid falling asleep. It is useful for people who have difficulty in falling asleep but not maintaining sleep.
- Cognitive behavioral therapy (CBT) the therapy examines you and tries to modify your beliefs and attitudes about insomnia.
These are some of the cognitive and behavioural treatment recommended for people with insomnia. Your doctor may refer you to a clinical psychologist for CBT.
Sleeping tablets: Sleeping tablets or hypnotics are medications that are used to help or improve sleep. Your doctor may recommend sleep medications if;
- your symptoms are very severe or insomnia is causing extreme distress.
- you have short-term insomnia.
- non-drug treatments do not improve your insomnia.
Your doctor may prescribe short-acting benzodiazepines (with short-lasting effects) such as temazepam, loprazolam, lormetazepam or Z medicines (such as zopiclone, zolpidem, zaleplon). The Z medicines are relatively new type of sleeping tablet but they work like benzodiazepines. As the benzodiazepines and Z medicines have similar type of action if one does not work, changing to other medicine may not have any significant effect.
Sleep medications have several side effects, can cause dependence and are not effective if they are taken for a long-time.It is advisable to take these medications in the smallest effective dose and for the shortest length of time necessary (for no longer than a week). If you are taking any sleep medicine regularly consult your doctor for advice regarding reducing or stopping them and other therapies that may help you.
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